What does it mean when a drug or medication is on back order How come you didn’t get the medication for me when I called in for the refill? What’s taking so long?
In the past year human and veterinary medicine has been plagued by a problem of getting the supplies we need. This problem is called back ordering Many times one of you has called us, requesting a refill on a medication that your pet may have been taking for years…and suddenly we couldn’t get it for you. Sometimes a substitute has been available, and sometimes only a short delay. But when an item is back ordered we have no control of when we can receive an item. Some items which have been back ordered (and are still on back order in some cases) are:
- Propofol
- Interceptor
- Sentinel
- Previcox
- Heparin
- Epinephrine
- Buprinorphine
- Levothyroxine
- Furosemide
So why have so many things been back ordered this year. There are many reasons.
There has been consolidation in the pharmaceutical field. This has led to not only fewer manufacturers of medications, but also fewer providers of raw ingredients. That means that when there is a problem anywhere in the chain, products from multiple manufacturers will be affected.
Many pharmaceuticals have been outsourcing overseas. When the FDA finally gets around to inspection of these facilities, they sometimes find fault and will not allow products to be imported to this country until changes are made. Sometimes plants will be closed. Fortunately, many companies have realized that outsourcing production or shifting production overseas has a larger cost and are beginning to shift production back to the United States. This is in essence a quality control issue. Plants in the US have been closed as well.
Sometimes, especially for generic drugs, it’s just not cost effective to continue production. So they simply stop making the medication. Eventually, someone else may take over production but this takes time.
Recalls have also taken a toll. A recall is issued by a manufacturer (generally just before a negative report is issued by the FDA or the press) about a product which is found to be dangerous (at least to someone). When this happens, the supply becomes zero until the problem causing the recall can be fixed.
So how can these problems be fixed?
In the short run, very little. The next few years will be difficult. But we need to convince drug companies that keeping business here, and practicing good, ethical, quality practices are much better than short term gains by cutting corners. Likely this will entail the government changing tax law, increasing inspection, and levying bigger penalties for violations. You must help strengthen consumer protections by contacting your elected officials.
What happens if my pet’s medication is back ordered?
Several things. First, we will find it’s been back ordered We will try every avenue to find the medication. If we can’t, we contact the manufacturer and try to find when it will be available. If the time frame is too long, we will try to see if a different form is available (liquid instead of tablet, brand name instead of generic). Sometimes the cost will be substantially higher. If we can’t find the drug, sometimes we can have a compounding pharmacy we trust make the drug from stock materials. This takes time and added cost as well. In some cases we will need to try a completely different medication.
But I found the medication on the internet!
Sometimes an on-line pharmacy will allow you to pay for the drug…and you will get it when it’s available (eventually). They may not tell you this ahead of time. Also, because many on-line pharmacies deal in “grey market” drugs, they frequently have re-sold drugs. Sometimes these drugs lack manufacturer warranty Again, you won’t be notified. Sometimes these drugs will be foreign made/labelled…sometimes from the manufacturing plants that the FDA deemed unfit. It’s much better to discuss the problem with us and to come up with a solution.
This seems like a lot of work for you. What do you charge to look into these medicine changes/research if a drug is back ordered?
Nothing. We consider this a part of patient care. It’s one of the advantages of getting medication directly from us or our on-line partner. Just remember that just as you will get frustrated with a back ordered food or medication, we get irritated too. Please be patient and let’s work together to get your pet what they need.